Masjid As-Siddiq: Youth Program Registration
Event Timing: December 22, 2018
Brothers: 4:00PM to 7:00AM Sunday, December 23, 2018
Sisters: 4:00PM to 11:00PM

Address: 117-25 133rd Street, South Ozone Park, NY 11420
Contact us at (718) 523-4167 or

For more questions on this event, please call:
Br. Naseeb: (516) 309-0470
Sis. Fanieza: (347) 322-4147

First Name *
Your answer
Last Name *
Your answer
Age *
NOTE: Only brothers and sisters AGES 10 AND UP are eligible for this youth program
Your answer
Phone Number *
Please enter your phone number in this format: 000-000-0000
Your answer
Email *
Your answer
Gender *
Never submit passwords through Google Forms.
This form was created inside of As-Siddiq Muslim Organization.